Why did I quit my private practice job.

First off, thanks for checking out my page, it’s a pleasure having you as a reader. Secondly, a little about myself. I’m a UK trained physiotherapist who graduated a little over 5 years ago now. When I applied to the undergraduate programme as a naive 18 year old I had the same vision all other football obsessed undergrads did, that one day I’d be running out onto a football pitch in front of 80,000 people to put my 3 hard years of study to use with my licence to use the magic sponge. Surprisingly 5 years after graduating the sponge feels like it may have lost some of its magic but thankfully some of my peers keep that magic alive by prodding things that are painful, sticking brightly coloured tape all over their patients, sticking needles randomly into peoples skin as well as putting low dosages of electricity on elbows, shoulders, and the occasional spine. More on that later.

Anyway, I specialised in MSK physiotherapy soon after graduating with the goal of climbing the greasy NHS ladder as quickly as possible and seeing where the profession would take me.

During my early couple of years as an NHS junior physiotherapist life was surprisingly easy. Shoulder impingement, easy- yellow theraband tied to the door. Tennis elbow? They sell a cracking strap for that in the chemist, Back pain? Its your posture of course! I’d fire up my computer, print out the exercises, book the patient back in for a few weeks time and when they’d return they would either be well on their way to getting better, or just the same.

But what about those patients who were not improving despite listening to my postural advice, despite me telling them to switch on their trans abs whenever they moved! Had my 3 years at university taught me nothing!?

It was at this time I opened the manual therapy door. Was this the secret ingredient I had been missing!? The senior physio’s I worked alongside would occasionally appear from behind the curtains to either grab the massage lotion, wheel in the ultrasound machine or grab a bizarre tool for treating “trigger points” (To me it looked like a sex toy I’d seen advertised in the back of a dirty magazine but to them it was “the Jacknobber”).  I decided it  was my time to dabble in the dark arts and armed with my jacknobber I got to work at stabbing it into my patients upper traps with all my might, now, finally I was a physiotherapist! I was a manual therapist junkie, the patients’ screams were my drug.

Lets fast forward to present day. I’ve seen lots of clinicians, I’ve heard them talk to patients, I’ve heard all the analogies and if I hear another physio tell a patient their back is like a jam donut or they need a scan to work out what’s wrong then I’m just about ready to strap a giant magnet to myself and jump in the MRI scanner!

Now this is not a personal attack on anyone I have ever worked with. My colleagues work hard! But lets take another profession, a pilot for example. Wouldn’t you like to hope that the pilot with your life in their hands is  keeping up to date with training, not doing what they once did 30 years ago!? Times change and we live in a world where we need to accept that maybe what we once did maybe was not right? Pilots are exposed to rigorous testing every 6 months to check they reach the high standards required to ensure the safety of the general public but as a physio many play Russian roulette praying they aren’t called up to present their CPD file to the HCPC rather than being proud of having kept up to date.

I dare you- google any private physio practice and the first thing you’ll find is how much experience the clinican has, the next page, the treatments they offer. Let’s play bingo, mobilisation, manipulation, acupuncture, trigger point release, massage. I could go on. 30+ years experience, experience in doing what the latest research suggests actually has minimal benefit, yet this has become accepted as modern day physiotherapy and the general public still gladly part with their hard earn cash for this? Why do these patients get better without evidence based treatments? Well that’s a whole blog in itself and one that I’ll revisit at a later date.

Sitting here typing this I don’t claim to know it all, in fact, I know very little. But what I do know about is morals.

Growing up we learn what’s right and wrong, don’t steal, treat others as you’d like to be treated and always eat your greens.

Well, personally, I felt like by entering the world of private practice too soon I hadn’t found my own approach to treatment, my approach was a mixture of the clinicans I’d worked alongside as a student, the very few research papers I’d read and the one or two courses I’d scraped together enough money to attend. As a result of the pressure of working for a well established private practice where the treatments were built around very little evidence I consequently felt my morals had gone out the window (except I was still eating my greens). But charging patients for treatment that lacks evidence because of feeling pressurised by more experienced clinicians because that’s how they do things!? I couldn’t keep on doing this.

What’s the harm if the patient gets better, you’re still getting paid, the business still makes money? Truthfully there is nothing wrong with it. Morally there is everything wrong with it and if you’re committed to personal development in the same way I and many others are then you too would have decided to get out before it consumed your morals and you become blinkered by the approaches of others.

So why did I start this blog. Well it sure as hell doesn’t make me the money that private practice did, but now I am free from the shackles where I never felt I could implement my own approach, I have the time to create content, express my opinions (yes, we are all entitled to one) and continue with my own personal development.

As a university student you’d often find me on the back row in the lecture theatre doodling cartoons, my notes would be full of them. That’s how I learn give me a page of writing vs a page of doodles containing the same information and I guarantee you that I’d retain the information from the doodles far quicker than a word document in Times New Roman, font size 12.

Check out my Facebook: The Honest Physio Instagram/Twitter @Honest_Physio if you’d like to check out my doodles, subscribe to the blog to read more of my rambles or don’t if I’m not your cup of tea. But whatever you decide remember your morals, remember that commitment to life long learning you made when you produced your personal statement for University and keep doing what the evidence shows!

 

That’s all for now,

 

The Honest Physio.

@Honest_Physio

3 thoughts on “Why did I quit my private practice job.

  1. I have 23 years experience and for the past 13 years, have been working within a gym, focusing on reassuring clients, teaching them how to move more efficiently and restoring movement patterns. The owners recently approached me to ask if they could rent out a room to another ‘traditional physio’ as they though that I did not treat acute injuries and just did rehab. Nothing that I said satisfied them that what I was doing (education, advice, movement) satisfied them that I could go up against a physio with machines and needles; and that what I do is evidence based and best practice. Apparently I don’t look different enough to some of their Chek trained personal trainers and massage therapists. They want me in the windowless room all day wrestling patients, applying needles and seeing them walk out with kinesiotape. Beyond insulted…
    Let me know if you have a job going – apparently best practice is not valued by the public!

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      1. I’m in Canberra, Australia. Could’ve written your post myself – over it and the ethics of private practice creating dependence and fear mongering to create business. I’m not into unicorn magic physio

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